Justia Health Law Opinion Summaries

After Talevski’s move to a nursing home proved problematic, Talevski sued a county-owned nursing home (HHC) under 42 U.S.C. 1983, claiming that HHC’s actions violated rights guaranteed him under the Federal Nursing Home Reform Act (FNHRA). The Seventh Circuit reversed the dismissal of the suit, concluding that the FNHRA rights cited by Talevski—the right to be free from unnecessary chemical restraints and rights to be discharged or transferred only when certain preconditions are met, “unambiguously confer individually enforceable rights on nursing home residents,” presumptively enforceable via section 1983.The Supreme Court affirmed. The FNHRA provisions at issue unambiguously create section 1983-enforceable rights. There is no incompatibility between private enforcement under section 1983 and the remedial scheme that Congress devised. The Court rejected HHC’s argument that, because Congress apparently enacted the FNHRA pursuant to the Spending Clause, Talevski cannot invoke section 1983 to vindicate rights recognized by the FNHRA. FNHRA lacks any indicia of congressional intent to preclude section 1983 enforcement, such as an express private judicial right of action or any other provision that might signify that intent. HHC cited the comprehensiveness of FNHRA’s enforcement mechanisms, but implicit preclusion is shown only by a comprehensive enforcement scheme that is incompatible with individual enforcement under section 1983. There is no indication that private enforcement under section 1983 would thwart Congress’s scheme by circumventing the statutes’ pre-suit procedures, or by giving plaintiffs access to tangible benefits otherwise unavailable under the statutes. View "Health and Hospital Corp. of Marion County v. Talevski" on Justia Law

Plaintiff (and IVYR PLLC, doing business as Par Retina) sued Wolfe Clinic, P.C. (and three of its owner-physicians). Plaintiff alleged that the Clinic monopolized or attempted to monopolize the vitreoretinal care market. On the merits, the district court initially dismissed the monopolization, fraudulent inducement, and recission claims while remanding the remaining state law claims. In an amended judgment, the district court denied Plaintiff’s motion to amend the complaint and affirmed the dismissal of the monopolization claims, but declined to exercise supplemental jurisdiction, dismissing all state law claims.   The Eighth Circuit affirmed. The court held that the district court did not abuse its discretion by denying Plaintiff’s motion to amend the complaint. The information in the amended complaint was previously available to Plaintiff and should have been pleaded before the judgment was entered. Plaintiff was on notice of the deficiencies in his complaint when the Clinic filed its motion to dismiss. Despite this, Plaintiff inexcusably delayed filing the Rule 59(e) motion—waiting over five months after the motion to dismiss was filed and almost a month after the district court dismissed the complaint. The court ultimately held that Plaintiff failed to plead a plausible claim for monopolization or attempted monopolization because he did not allege a relevant geographic market. View "George Par v. Wolfe Clinic, P.C." on Justia Law

The First Circuit affirmed the decision of the district court dismissing with prejudice Relators' qui tam suit brought under the False Claims Act (FCA), 31 U.S.C. 3729, against DePuy Orthopaedics, Inc. and related entities (collectively, DePuy) alleging a fraudulent scheme involving hip replacement devices sold by DePuy, holding that the district court did not abuse its discretion.The district court dismissed this case with prejudice under Fed. R. Civ. P. 41(b) for failing to comply with multiple protective and court orders that governed Relators' use of confidential information. The First Circuit affirmed, holding (1) the district court did not err by granting DePuy's motion for reconsideration and to set aside, amend, or later the district court's final judgment; (2) the district court did not abuse its discretion in finding that Relators had violated protective orders and in imposing the sanction of dismissal with prejudice; and (3) Relators were not entitled to relief on their remaining allegations of error. View "U.S., ex rel. Nargol & Langton v. DePuy Orthopaedics, Inc." on Justia Law

Petitioners filed this original proceeding objecting to two pieces of legislation passed by the Oklahoma legislature during the 2022 legislative session: S.B. 1503 and H.B. 4327. Both acts prohibited abortion after certain cutoff points while providing for a civil enforcement mechanism; both acts prohibited enforcement by the State, its subdivisions, and its agents--instead, the bills created a cause-of-action maintainable by any person for performing, or aiding and abetting the performance of, an abortion in violation of the acts. Petitioners challenged the bills on many grounds, but the Oklahoma Supreme Court did not address them here. The Court held both bills were unconstitutional; the Court found it unnecessary to address the Petitioners' request for injunctive relief and/or writ of prohibition or Respondents' claims that Petitioners did not have a justiciable claim against them. Petitioners' request for injunctive relief and/or a writ of prohibition was denied. View "Oklahoma Call for Reproductive Justice v. Oklahoma" on Justia Law

As four medically comprised inmates who required skilled nursing care were approaching their parole dates, the California Department of Corrections and Rehabilitation (CDCR) unsuccessfully attempted to locate post-parole skilled nursing facilities. When their parole dates arrived, the CDCR paroled them to Kern County and transported them to the emergency department at Kern Medical Center (KMC), a licensed general acute care hospital. Kern County Hospital Authority (Hospital Authority), which operates KMC, sought a peremptory writ of mandate and injunction against the CDCR and its Secretary.The trial court granted the Writ, and the CDCR appealed, arguing it does not have a ministerial duty to obtain Hospital Authority’s express consent before transporting parolees to KMC’s emergency department.The Fifth Appellate District reversed, holding that the Department failed to comply with regulation 79789 when transferring the parolees to KMC, and therefore abused its discretion. However, finding that the injunction was overbroad, the Fifth Appellate District remanded to the trial court for issuance of a new peremptory writ. View "Kern County Hospital Auth. v. Dept. of Corrections & Rehabilitation" on Justia Law

The Supreme Court affirmed the order of the trial court on interlocutory appeal denying Defendants' remand for a jury in this argument over the requirement that civil enforcement actions brought by the attorney general "shall be by equitable proceedings," holding that the requirement was enforceable and did not violate the jury right preserved by Iowa Const. art. I, 9.The attorney general commenced this action alleging that Defendants had violated the Iowa Consumer Fraud Act (CFA), Iowa Code 714.16, and the Older Iowans Act (OIA), Iowa Code 714.16A, by engaging in false and deceptive conduct and unfair practices in the "sale and advertisement of stem cell and exosome therapy in Iowa." Defendants answered and demanded a jury, but the attorney general moved to strike the jury demand because subsection 714.16(7) requires that civil actions "shall be by equitable proceedings." The district court granted the motion to strike, and Defendants applied for interlocutory review. The Supreme Court affirmed, holding that the district court did not err in striking Defendants' jury demand. View "State ex rel., Attorney General" on Justia Law

The Supreme Court held that a reimbursement cap imposed by the Tennessee Department of Finance and Administration's Division of TennCare, the state agency tasked with administering the federal Medicaid program in Tennessee, was a "rule" within the meaning of the Uniform Administrative Procedures Act that should have been promulgated through the notice-and-comment process.Emergency Medical Care Facilities, P.C., a corporation compromised of private healthcare professionals who provide emergency-department services to TennCare enrollees, brought this action against TennCare alleging that TennCare's decision to impose a $50 cap on the amount that Emergency Medical and other healthcare professionals could recover from TennCare for certain treatment provided to TennCare enrollees was a rule and that TennCare violated the Tennessee Uniform Administrative Procedures act (UAPA) by implementing the cap without rulemaking. The chancery court granted summary judgment in favor of Emergency Medical. The court of appeals reversed, concluding that the $50 cap fell within the so-called "internal-management exception" to the UAPA. The Supreme Court reversed, holding that the $50 cap was a rule under the UAPA and should have been promulgated through notice-and-comment rulemaking. View "Emergency Medical Care Facilities, P.C. v. Division of Tenncare" on Justia Law

The First Circuit affirmed in part and reversed in part in this case brought against three Maine government officials in their official capacities (collectively, the State) and several healthcare providers (the Providers) by Plaintiffs, seven healthcare workers whose employment was vaccinated after they refused to accept COVID-19 vaccination (collectively, the Providers), holding that the court erred in dismissing certain claims.In 2021, under the "Mandate," Maine required certain healthcare facilities to ensure that their non-remote workers were vaccinated against COVID-19. Plaintiffs alleged that their sincerely-held religious beliefs prevented them from receiving any of the available COVID-19 vaccines and requested that their employers, the Providers, exempt them from the vaccination requirement. The Providers refused and terminated Plaintiffs' employment. Plaintiffs brought this suit alleging several claims. The district court dismissed the complaint in its entirety. The First Circuit reversed in part, holding that the district court (1) did not err in dismissing Plaintiffs' claims brought under Title VII of the Civil Rights Act of 1964; but (2) erred in dismissing Plaintiffs' claims for relief under the Free Exercise and Equal Protection Clauses. View "Lowe v. Mills" on Justia Law

Eight South Florida hospitals dutifully provided out-of-network emergency treatment to numerous Cigna customers. When Cigna reimbursed the hospitals just 15% of what they had charged, the hospitals sued, accusing Cigna of paying less than the “community” rate. As proof, the hospitals showed that they normally receive five times as much for the care they provided here. In response, Cigna asserted that the hospitals’ data proved nothing because, it insisted, the relevant “community” necessarily includes more than just the eight plaintiff hospitals. The district court agreed and granted Cigna summary judgment.   The Eleventh Circuit reversed. The court explained that even if the relevant “community” here extends beyond the eight plaintiff hospitals, their receipts alone are enough to create a genuine factual dispute about what the “community” rates are. The court reasoned that to survive summary judgment, a plaintiff needn’t present evidence that compels a single, airtight inference—just evidence that allows a reasonable one. The court explained that the way to rebut an inference allegedly skewed by limited data is to add data. And Cigna can do just that—at trial. If it can show there that most other providers in the “community” charge less than the plaintiff hospitals do, then it may well debunk the hospitals’ estimate. But unless and until that happens, it remains the case that a reasonable jury could conclude that the eight plaintiff hospitals’ rates reflect the prevailing community rate—and thus that Cigna shortchanged them. View "North Shore Medical Center, Inc., et al v. Cigna Health and Life Insurance Company" on Justia Law

Plaintiff was employed by Defendant and, as a condition of employment, was required to get a flu vaccine. Plaintiff sought an exemption based on a medically recognized contraindication, presenting a doctor's note that recommended she avoid the vaccine based on her history of cancer and general allergies. However, neither of these was a medically recognized contraindication, and Defendant terminated her employment.Plaintiff filed suit under the FEHA for disability discrimination. The trial court granted summary judgment in Defendnat's favor, plaintiff appealed.The Second Appellate District affirmed, finding that Defendant did not engage in disability discrimination and that Defendant's reason for terminating Plaintiff's employment was legitimate and lacked pretext. Further, the court rejected Plaintifff's retaliation claim. View "Hodges v. Cedars-Sinai Medical Center" on Justia Law